THURSDAY, Oct. 25 (HealthDay News) -- There's a troubling gap between how well asthma patients in the United States think they have the disease under control and how it actually affects their daily lives, according to a survey released Thursday by the Asthma and Allergy Foundation of America (AAFA).

Two-thirds of the survey respondents said they have their asthma symptoms under control, but more than half reported experiencing symptoms such as shortness of breath, wheezing, coughing, chest tightness and/or phlegm production at least once a week.

"These survey findings illustrate the need for a better standard of control when it comes to managing asthma," Mike Tringale, the AAFA's director of external affairs, said in a prepared statement. "There is a large disconnect between what asthma patients are saying and how they are actually affected by asthma every day, which calls for better education on how to properly control the disease."

The survey, which the AAFA sponsored in collaboration with drug maker AstraZeneca, included more than 4,000 adults aged 18 and older. Among the findings:

• Asthma was three times more prevalent among people who live with a family member who is also diagnosed with asthma than in the general population.
• About 62 percent of asthma patients said asthma limits their usual activities or enjoyment of life every day to varying degrees.
• Almost all asthma patients (92 percent) said they experienced at least one of the five common asthma symptoms in the past year (shortness of breath, wheezing, coughing, chest tightness, phlegm production). More than half (63 percent) said they experienced symptoms at least once a week, and 29 percent said they experienced at least one symptom a day.
• While 68 percent of asthma patients reported that their condition is well controlled, 74 percent said they would like to better control their asthma.
• Most asthma patients (59 percent) try to avoid taking asthma medications whenever possible, which suggests that they are not properly controlling the disease.
• One in three (33 percent) asthma patients used a rescue inhaler at least daily, and 73 percent have used a rescue inhaler at least once in the past month.

"Using a rescue medication regularly is a sign that asthma is not properly controlled, and you may be ailing from the disease unnecessarily," Dr. William E. Berger, of the division of allergy and immunology at the University of California, Irvine, said in a prepared statement. "According to NAEPP (National Asthma Education and Prevention Program) respiratory guidelines, asthma patients should ideally use their rescue inhaler twice a week or less."

The survey also examined a number of specific groups of asthma patients and found:

• Two-thirds (65 percent) of female asthma patients said the condition limits their usual activities or enjoyment of daily life to varying degrees, and 95 percent said they'd experienced at least one of the five common asthma symptoms in the past year.
• Only 8 percent of Hispanic respondents said they'd been diagnosed with asthma, but 58 percent said they'd experienced asthma symptoms.
• While 13 percent of black American respondents said they'd been diagnosed with asthma, 58 percent reported experiencing asthma symptoms.
• Compared to the general sample population, black American respondents were less likely to know about specific asthma risk factors, such as respiratory infections (71 percent vs. 58 percent) and living in an inner city (68 percent vs. 55 percent).

More information

The American Academy of Family Physicians has more about asthma control  .

THURSDAY, Oct. 25 (HealthDay News) -- Airway bypass to treat emphysema patients shows promise, researchers say.

Emphysema, a component of chronic obstructive pulmonary disease (COPD), is a progressive, irreversible lung disease characterized by the destruction of lung tissue. Treatment options are limited.

The new strategy, called airway bypass, is a minimally invasive, catheter-based bronchoscopic technique designed to reduce lung overinflation and improve breathlessness. It does so by making new pathways for trapped air to exit the lungs, according to background information in the study.

During airway bypass, new openings are created in the airway wall connecting the damaged lung tissue to the natural airway. These new pathways are supported and kept open by Exhale Drug-Eluting Stents.

This feasibility study, published in the October issue of the Journal of Thoracic and Cardiovascular Surgery, found that patients showed a statistically significant reduction in the amount of air trapped in the lungs, as well as an improvement in breathing for patients at six months after the procedure.

The results were released by Broncus Technologies Inc, the maker of the Exhale stents.

More information

The American Lung Association has more about emphysema  .

WEDNESDAY, Oct. 24 (HealthDay News) -- Timely use of a month's worth of inhaler medicine may have lessened rescue workers' respiratory symptoms in the wake of the Sept. 11, 2001, World Trade Center attacks, according to new findings announced Wednesday.

Inhaled corticosteroids (ICS) are anti-inflammatory medicines commonly used for the treatment of asthma. No study had ever examined whether administrating ICS before the onset of symptoms could ease those symptoms or prevent the onset of respiratory problems following exposure to inhaled particulates.

The 9/11 attacks jettisoned countless tons of particulate materials into the air above New York City. Many of those who labored to rescue the survivors, collect the remains, and clean up the debris have suffered over the past six years from a host of acute and progressive respiratory problems, including sinusitis, asthmatic symptoms, and the so-called "World Trade Center cough," among other problems.

Beginning one week after 9/11, a team led by Dr. David Prezant, chief medical officer in the Office of Medical Affairs, and co-director of WTC Medical Monitoring and Treatment Programs at the New York City Fire Department, offered the ICS drug budesonide to the approximately 11,000 NYC firefighters involved in cleanup and rescue efforts at the WTC site.

Almost 3,000 firefighters agreed to participate in the trial, during which the drug was inhaled twice a day for four weeks. Only 220 stuck with it for the full study period -- not because of side effects, the authors noted, but mostly from a lack of any immediate effect.

Two years later, the researchers assessed the treatment's effectiveness in relieving respiratory symptoms and improving lung function in those individuals who completed the treatment, relative to untreated control subjects.

Survey results indicated that those workers who received budesonide did see greater improvements in respiratory symptoms compared to their untreated counterparts, despite the fact that the treated group also tended to have greater unprotected exposure to the site. However, clinical tests failed to detect differences in lung function or airway reactivity, according to the study.

That finding suggests the drug targets workers respiratory symptoms but not the underlying cause, said Dr. Len Horovitz, an attending physician in the department of pulmonary medicine at Lenox Hill Hospital in New York who has tended to "a few" WTC patients (mostly volunteers and residents).

"You want to believe when you relieve symptoms, you are ameliorating the disease process, but that's not always the case," Horovitz said. "That's not clear, and, in most of these patients, their pulmonary function continued to decline, so it would appear they didn't halt the process itself."

Prezant could not be reached for comment. But Dr. Alvin Thomas Jr., president of the American College of Chest Physicians, said a subsequent re-analysis of the data by Prezant produced what the authors called a "small but significant improvement in the lung function" of workers who received treatment.

Thus, "inhaled corticosteroids may help prevent respiratory problems ... [and to] help ameliorate [mild] symptoms that develop," said Thomas. He stressed that additional studies will be needed to verify that conclusion, however.

The research was to be presented Wednesday at the annual international scientific assembly of the American College of Chest Physicians, in Chicago.

So, what should rescue workers do the next time they are called upon to work amid the dust of collapsing buildings? First, protect the lungs, said Horovitz. Even a handkerchief or a T-shirt placed over the nose and mouth can block larger particles from the airway.

If at all possible, said Thomas, workers should use a respirator. Unlike a handkerchief, or even the surgeons' masks available at most drugstores, respirators trap the microscopic particles that can get deep into the lungs and cause long-term problems.

And, if there is any chance of exposure to toxic inhalants, he added, start taking ICS as soon as possible.

"Prezant's study suggests that if you don't have a mask that you have complete confidence in, you should still use the inhaler, because particles can still get through and cause symptoms," he said.

More information

For more on the health effects of the 9/11 attacks, visit the New York City Department of Health and Mental Hygiene.